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   Table of Contents - Current issue
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October-December 2019
Volume 68 | Issue 4
Page Nos. 253-315

Online since Friday, February 28, 2020

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ORIGINAL ARTICLES  

A retrospective study on the relationship between maxillary posterior teeth and maxillary sinus floor using cone-beam computed tomographic images p. 253
Lijie Tang, Laiqing Xu, Hongchen Liu
DOI:10.4103/JASI.JASI_81_19  
Introduction: The aims of this study were to evaluate the distance and relationship between the root apex of maxillary posterior teeth and the maxillary sinus floor (MSF) and whether they varied with age. Cone-beam computed tomographic (CBCT) images covering maxillary sinus taken in our department from December 2015 to December 2016 were retrospectively analyzed. Material and Methods: Totally 221 CBCT images of maxillary posterior teeth were analyzed. The distance and relationship between the root apex and the MSF was measured and categorized into four types. The data were correlated with age. ANOVA, Fisher's exact test, Cochran–Armitage trend test, Pearson's Chi-square test were used. Results: For the second premolar, the distance from the apex to the MSF was the furthest compared to first and second molars. The majority of apices were located below the MSF. For the first molar, the palatal root owned the shortest distance (2.79 mm) (P < 0.05) and highest frequency (11.8%) in Type IV (root protruded into the MSF) in all teeth. For second molar, the mesiobuccal root had the minimum distance (2.08 mm) (P < 0.05) in all teeth and the second highest frequency (11.0%) in Type IV. In young people (20–40 years), the shorter distance and higher frequency in Type IV differed significantly compared to other age groups (P < 0.05). Discussion and Conclusion: The data verified the close relationship between the root apex of maxillary posterior teeth and the MSF. Age was a key factor to correlate the relation. Special care should be taken when dealing with maxillary posterior teeth, especially for young people.
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Discriminant function analysis of craniometric traits for sexual dimorphism and its implication in forensic anthropology p. 260
Balakrishnan Ramamoorthy, Mangala M Pai, Sonali Ullal, Latha V Prabhu
DOI:10.4103/JASI.JASI_82_19  
Introduction: Determination of sex from bony elements is the fundamental step to human virtue. Scholars agree highly accurate sex identification can be done from adult skulls. Direct assessment of the bones is not always the most appropriate or practical. Medical advances have provided cross-sectional slices of scanned individuals in the form of computed tomography (CT). The aim of the present study was to examine the reliability of cranial measurements for sex differences in CT head scan records of adult live subjects to the highest possible percentage in South Indians and to develop discriminant function equations. Material and Methods: Seventy head CT records were taken and 16 parameters were measured using RadiAnt DICOM viewer software. Statistical analysis was performed using descriptive statistics, Student's t-test, and discriminant function analysis. Results: The classification accuracy obtained by multivariate analysis of all 16 variables was 97.1%, multivariate analysis of nine most significant variables was 91.4% and by stepwise was 92.9% and that by univariate analysis for bizygomatic breadth, orbital breadth, basion-bregma height, and inter-orbital breadth was 81.4%, 74.3%, 72.9%, and 70%, respectively. Discussion and Conclusion: Multivariate analysis gave the highest classification accuracy and bizygomatic breadth, orbital breadth, basion-bregma height, and inter-orbital breadth were the most dimorphic variables in the study population and several other populations, and thereby should always be considered in the sex determination of humans. The study derived specific discriminant functions for sex determination in the South Indian population, providing a population-specific data for sex determination using craniometric parameters in the South Indian population and for future studies on skeletalized remains.
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Saraswatarishta reverses neuronal injury in brain tissues of scopolamine-induced rat model p. 269
Jai Prabhu, S Jayakumari, K Prabhu, Jyothi Ashok Kumar, Manickam Subramanian, Kavimani
DOI:10.4103/JASI.JASI_45_19  
Introduction: Neuroinflammation has been implicated in the pathogenesis or the progression of the variety of acute and chronic neurological and neurodegenerative disorders, including Alzheimer's disease. The Saraswatarishta is an Ayurvedic medicine utilized in many health conditions such as anti-aging, to improve memory, immunity, and quality of semen and sperms to treat epilepsy and cosmetic use for skins. It is a liquid Ayurvedic medicine. Saraswatarishta contains 5%–10% of self-produced alcohol in it, which serves as a vehicle to deliver water- and alcohol-soluble active herbal components to the body. It is also called Sarasvatarishtam. The aim of this study was to find the possible neuroprotective role of Saraswatarishtam as a preventive Ayurveda and Siddha drug to hamper cholinergic dysfunctions and histopathological changes in scopolamine-treated rat model. Material and Methods: The compound Saraswatarishtam was obtained from standard Ayurvedic vendor at Chennai. Group 1 – normal control animals received normal saline for 8 continuous days. Group 2 – positive control treated with scopolamine (0.4 mg/kg). Group 3 – received 200 mg/kg of piracetam for 8 continuous days. Group 4 and Group 5 served as a test and received 200 mg/kg and 400 mg/kg of Saraswatarishtam, respectively, for 8 continuous days. On the 8th day, after 90 min of drug administration, Group 2, Group 3, Group 4 and Group 5, were treated with 0.4 mg/kg of scopolamine. Brain tissues were dissected out and analyzed for histopathological changes after sacrifice with high dose of halothane. Results: Administration of scopolamine produced marked focal gliosis with mononuclear infiltration. The hippocampal region showed neuronal degeneration with sclerosis. Piracetam treated group showed pyknotic nucleus in neurons of the cerebral cortex and mild edema. Low dose (200 mg/kg) treatment with Saraswatarishtam followed by scopolamine administration showed moderate histopathological changes such as mild infiltration of monocytes but normal neuronal architecture. High dose (400 mg/kg) treatment with Saraswatarishtam followed by scopolamine administration shows abnormal morphology of cerebrum, cerebellum, basal nuclei, and hippocampus. Discussion and Conclusion: The results of the present study suggested that Saraswatarishtam exhibits neuroprotective properties against scopolamine-induced neuronal damage.
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Stature Estimation from Foot Radiographs of North Indian Population p. 274
Vishram Singh, V Chakradhar, Yogesh Yadav, Rashi Singh
DOI:10.4103/JASI.JASI_229_19  
Introduction: Stature is necessary for medical, nutritional assessment, age, and race identification. The present study aims to measure the radiographic foot angles in different age groups of the North Indian population, National Capital Region, New Delhi, correlating it with the height of the individual. Material and Methods: The study was done for 1 year from September 2016 to November 2017 carried out on 257 individuals. Calcaneal pitch angle (CPA), talohorizontal angle, talocalcaneal angle (TCA), talo- first metatarsal angle (TFMA), and radiological foot length (RFL) were measured using radiographs of all the patients. Results: Results concluded that, among all the parameters, the radiographic length of the left and right foot was more correlated followed by TCA on the left side and right side with the stature. The correlation equation came to be Y = 69.97 + 4.18*X (Y = height and X = radiographic foot length for the right foot). The correlation equation was Y = 72.7 + 4.05*X (Y = height and X = Radiographic foot length for the left foot). Discussion and Conclusion: There is a positive correlation for talocalcaneal, TFMAs, and RFL on both sides with the stature of the patient. CPA and talohorizontal angles were negatively correlated with the stature. More studies involving a large number of patients could help to draw a valid conclusion.
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Spectrum of congenital cardiac malformations in dextrocardia: A single institute study p. 279
Vikas Kumar, Rana Sandip Singh, Anand Kumar Mishra
DOI:10.4103/JASI.JASI_69_19  
Introduction: Complex congenital heart malformations are associated with dextrocardia depending on the situs. The objective is to present the spectrum of cardiac malformations and the surgical interventions done in patients with dextrocardia at our tertiary care institute over 5 years. Material and Methods: A retrospective study of patients with dextrocardia undergoing some form of cardiac surgery at our institute from January 2012 to December 2016 was done. Seventeen cases were identified, and their records were reviewed. Results: Of 2231 cardiac surgeries done for congenital heart disease, there were 17 (0.76%) patients with dextrocardia with male predominance (70.58%). The mean age was 5.69 ± 6.66 years. Of 17 patients, 9 had situs inversus, 7 had situs solitus, and 1 patient had situs ambiguous. Thirteen patients (76.47%) had functional single-ventricle physiology. Six of them (46.15%) had situs solitus, 6 (46.15%) had situs inversus, and situs ambiguous in 1 (7.69%). Biventricular repair was possible in 4 patients (23.52%), of which 3 had situs inversus and 1 had situs solitus. Three patients had ventriculoarterial (VA) discordance and 2 had atrioventricular and VA discordance. There were two early mortalities and three late mortalities, all of them had single-ventricle physiology. Discussion and Conclusion: Dextrocardia is a rare congenital anomaly with wide variations of complex congenital cardiac malformations. It is associated with all forms of spatial relationships of visceral organs with situs inversus being the most common.
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Body-height predictions with lower extremity length in the mentawai ethnic group p. 285
Rika Susanti, Taufik Hidayat, Citra Manela
DOI:10.4103/JASI.JASI_212_19  
Introduction: This study was aimed to determine the correlation between body-height with lower extremity length and to predict the formula for body-height prediction of the Mentawai ethnic group. Material and Methods: The research was conducted at several places on Sipora Island with a sample size of 201 persons and analyzed through a Spearman correlation test as well as simple and multiple linear regression analyses. Results: The simple linear equation for male upper leg was Y = 130.291 + 0.674 upper leg length (±7.496), female Y = 129.484 + 0.489 upper leg length (±4.522) and for male Lower leg was Y = 130.488 + 0.934 lower leg length (±4.520), female Y = 129.423 + 0.681 lower leg length (±3.590). The multiple linear regression equation for males was Y = 114.193 + 0.437 upper leg + 0.81 lower leg (±6.615) and for females was Y = 117.150 + 0.357 upper leg + 0.572 lower leg (±4.773). Discussion and Conclusion: The Mentawai ethnic adult aged male body height, upper leg length, and lower leg length were greater than in females. As well, there was a significant correlation between body height with upper leg length and lower leg length.The obtained regression equotions can be used in the future to predict Mentawai ethnic adult-aged male and female body-heigth.
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A cadaveric study for preoperative estimation of length of palmaris longus tendon in reconstructive surgeries p. 290
Monika Lalit, Sanjay Piplani, Anupama Mahajan, Anterpreet Kaur Arora
DOI:10.4103/JASI.JASI_106_19  
Introduction: The palmaris longus (PL) muscle is described as one of the muscles with most anatomical variations and classified as a muscle in phylogenetic regression. The aim of this study is to demonstrate that the tendon of the PL muscle can be estimated in relation to its length and width before using it as a graft in any surgical procedure. Material and Methods: The material for the present study consisted of 40 limbs (20 – right and 20 – left) of different age groups and sex (28 males and 12 females). The limbs were made available in the Anatomy Department for dissection purpose at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab. The forearm length (FAL) and PL tendons length (TL) and width (TW) were measured. Degree of association between measurements was calculated by Pearson's correlation coefficient. Results: The mean TL and TW in male cadavers (15.918 ± 1.462 cm and 0.463 ± 0.100 cm) was more than in female cadavers (15.050 ± 1.046 cm and 0.355 ± 0.060 cm) and PL-TW was found to be statistically significant (P < 0.001). The mean FAL in male cadavers (23.025 ± 2.050 cm) was more than in female cadavers (20.483 ± 1.109 cm) and was found to be highly significant (P < 0.001). A statistically significant correlation was observed between TL and FAL in males (P = 0.010) and in females (P = 0.021). However, TW presented a statistical significance in males only (P = 0.025). The mean TL of the left side (15.690 ± 1.336 cm) was slightly more than the right side (15.625 ± 1.489 cm), whereas the mean TW of the right side (0.435 ± 0.099 cm) was slightly more than the left side (0.426 ± 0.108 cm). The mean FAL on the right side (22.295 ± 2.272 cm) was slightly more than the left side (22.230 ± 2.091 cm). Discussion and Conclusion: The statistically significant correlation observed between the PL-TL and the FAL indicates that the PL-TL can be predicted for reconstructive surgeries preoperatively.
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Students' perception of vertical integration for topics of applied anatomy in 1st year MBBS p. 295
Shalini Kumar, Musharraf Hussain
DOI:10.4103/JASI.JASI_91_19  
Introduction: There is a rapid change in medical education around the world; as a result, the Medical Council of India (MCI) has put forward guidelines for various medical colleges for effective and need-based curriculum for MBBS. Integrated teaching is most important aspect of this modified competency-based curriculum. Hence, the aim is to introduce the vertical integration and assess the students' perception for topics of applied anatomy in 1st year MBBS students. Material and Methods: A prospective study was conducted on 93 1st year MBBS students who consented for this study in the Department of Anatomy, HIMSR, Delhi, after getting approval from the institutional ethics committee. Integrated lectures for two applied anatomy topics were conducted by the faculty of anatomy and surgery. Questionnaire was provided for the feedback of the students. Results: A total of 93 MBBS students participated. Eighty-two percent of students like the session of integrated teaching and found it very useful to understand the topic. Seventy-three percent of students appreciated content, methods, and presentation of integrated teaching session, and hence, the learning objectives were achieved. Seventy-eight percent of students strongly agreed that integrated teaching helped them in better retention of topic. Eighty percent of students strongly felt that integrated teaching method should be incorporated as teaching–learning methods for some more topics of applied importance. Discussion and Conclusion: The students recognized the importance of integrated teaching. They found this session interesting and wish that these should be continued for other topics also regularly and frequently. Hence, integrated teaching should be implemented in medical curriculum for effective teaching.
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Cadaveric study of extensor retinaculum of the wrist p. 299
Pornhatai Komutrattananont, Treerat Gumpangseth, Shohei Omokawa, Pasuk Mahakkanukrauh
DOI:10.4103/JASI.JASI_84_19  
Introduction: The function of the wrist extensor retinaculum is to prevent the extensor tendon bowstringing. Because the retinaculum is damaged by hand trauma and surgical exposure during the wrist surgery, the knowledge of anatomy of the retinaculum helps surgeons to restore the normal function of the extensor retinaculum. Material and Methods: The morphological variation of the retinaculum and average length and width of both septal attachment of the retinaculum were examined using 50 fresh donor cadavers. Results: Our finding found that the extensor retinaculum was white thickening fascia which arranged in transverse direction across over the wrist extensor group. The original retinaculum was defined as the part inserted from the radius to the pisiform and triquetrum. The mean length was ranging 10–35 mm and the mean width of proximal and distal end was 62–93 mm and 64–89 mm, respectively. There were supplemental retinaculums where was located on the proximal and distal to the original retinaculum. These retinaculums were thinner and more translucent. We found four patterns of attachment sites of the proximal retinaculum and five patterns for the distal extensor retinaculum. In addition, the average septal attachment size was varied from 1.24 to 27.81 mm in length and width was 0.33–20.50 mm for the real retinaculum. W also found the 84% present of the septal attachment beside the 6th compartment in ulnar side. Discussion and Conclusion: The knowledge of anatomical characteristic of the extensor retinaculum includes morphology, dimensions, and septal attachment is benefit for surgery.
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REVIEW ARTICLE Top

Dissecting the future: A critical review of anatomy's past, present, and future following the carnegie foundation's call for medical education reform Highly accessed article p. 306
Hassan Amiralli, Sherese Joseph
DOI:10.4103/JASI.JASI_23_19  
By looking at anatomy's past and present, anatomists can acquire an overview of where the profession has been and where it now needs to go to meet the needs of 21st century medical education. This paper reviews past and present pedagogy and offers an alternative approach to the future of anatomy education through the use of digital dissection and more integrative didactic experiences.
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CASE REPORT Top

A gastrosplenic trunk in association with a replaced common hepatic artery arising independently from the superior mesenteric artery: A case report using multidetector computed tomography angiography p. 312
Laura-Andreea Bolintineanu, Nicoleta Iacob, Petru Matusz, Agneta Maria Pusztai
DOI:10.4103/JASI.JASI_78_19  
The authors report the case of a 51-year-old male that shown to have, independently of the vascular lesions of the lower limbs, the presence of a gastrosplenic trunk (GST) in association with a replaced common hepatic artery (CHA), arising from the superior mesenteric artery by multidetector computed tomography angiography. The GST with an endoluminal diameter of 5.6 mm at its origin and a length of 18.8 mm arose from the anterior wall of the AA at the level of middle 1/3rd of the L1 vertebral body. The replaced CHA with an endoluminal diameter at the origin of 4.8 mm has a lateral right ascendent path, initial in front of the superior mesenteric vein, in the middle portion penetrating the pancreatic parenchyma, in the terminal portion crossing the anterior aspect of hepatic portal vein, and finally fork in the gastroduodenal artery and hepatic artery proper. The knowledge of the variations of the GST and the replaced CHA is important for planning and performing procedures such as duodenopancreatectomy and liver transplantation.
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